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What? There is nothing I don’t know about hygienists. Not so. If you don’t know these four things you are destined to have hygiene turnover, poor productivity and, worse, poor patient retention. Few doctors take the time to craft a great hygiene department. Too many use it as a “loss leader” and/or a necessary evil that is way too expensive. Not me. My hygienists did at least 33% of the production in my office and were the key to our case presentation achieving a 90% plus acceptance rate. How many times do we throw our money away on hair-brained services and products that just fizzled and drove us deeper into debt? Not so in hygiene. Any time or money you spend designing systems and protocols while partnering with your hygienists will pay wonderful dividends year after year after year. And when you get ready to hang up the handpiece and retire, your practice will sell for thousands above average.

Here are the four things you don’t know about hygienists that will cost you thousands of dollars a month.

  1. Doctors don’t know the two times hygienists are upset with us. Number one: The times you keep them waiting. Your inattention to everyone’s schedule causes you to always run behind, while also sabotaging your hygienist’s schedule. This one factor always lowers case acceptance, patient approval, and any rapport you had with your hygienist. You need every hygienist on your side and there are consistent protocols and systems that will insure this. Secondly: They are upset when you are in their room. Because of your insecurity or approval addiction, you tend to drag out the time spent in the hygiene check to the point that you get further behind as well as wrecking the hygiene schedule. This constant inability to correctly interface with patients while staying on schedule only perpetuates a poor average case acceptance of around 60%. I have a solution for this in great detail at the end of this article.
  2. Doctor’s think that hygienists can’t read an x-ray or record current conditions in a patient’s mouth. While hygienists cannot legally “diagnose” a patient, they can “triage” them. This happens all day long in a hospital or doctor’s office. I don’t know how this myth got started, but I’ll bet part of perpetuating it comes from the doctor’s inability to delegate or their insecurity about their fees and clinical acumen. In truth, when hygienists are trained in school they are tasked with the requirement to record existing conditions, note any problems, probe, oral cancer exam, soft tissue exam, explain treatment options and finally clean the patient’s teeth. Following this exhaustive formal new patient exam, consultation, and cleaning, a Dentist comes by and checks everything. If they miss any needed treatment, they have their butts chewed by that doctor. Fast forward to the time they end up in your office and you relegate your hygienist(s) to just cleaning patient’s teeth, while leaving the really important task of helping patients understand and accept treatment until you magically appear after everyone has been waiting for 20-30 minutes for you to get there. I have a solution for this too at the end of the article.
  3. Doctors think their hygienists are consistently pre-booking patient’s future appointments in hygiene.   You better wake up and go check. It is as easy as looking out 4 or 5 months and seeing what the hygiene schedule looks like. The goal is over 80% booked for future check-ups. The national average ends up being around 42%. Average practices don’t grow, have high overheads, and don’t spin off much, if any, profit. No one wants to be average. Once you find out what the future looks like, you need to confront each hygienist with their recall record and tell them you expect them to pre-book everyone. Failure to monitor the results in your office and not having consequences for your employees creates the foundation for the failure of almost any system. Note: Only the hygienist who cleans a person’s teeth should make the appointment in the future. I have a solution for this at the end of the article.
  4. Doctors think hygienists need one hour for a recall prophy and exam. Are you kidding me? No one needs 60 minutes for a cleaning. They may need 63 or 47 but no one needs exactly 60 minutes. The truth is that if you pay hygienists hourly they will have a patient every hour. This is a poor habit left over from the days when we all had fee for service practices and no one really had insurance. Of course, they were paid much less then. But now, with practices approaching 74% in-network clientele, raising fees does not raise your reimbursement. So hygienists should never get longevity based raises or cost of living raises without first producing more. Hourly wages are the worst way to pay an individual that has the ability to raise their productivity by working more efficiently and/or effectively. Making appointments on the hour also drives the front desk crazy because every hour on the hour they have 4 or more patients arriving for an appointment and an equal number leaving. This just causes chaos for the front desk as well as for your schedule.   Let’s assume that you find yourself controlled by dominant hygienists and you don’t think you can make the actual changes you need to make to see a huge reversal in your results. If you went from a 60-minute schedule in hygiene to a 50-minute recall schedule, you would have 80 more minutes a day that if filled could increase hygiene production by 31%.

Michael Abernathy, DDS
972-523-4660 cell
[email protected]

    PS. Here’s what I promised above. The answer is go to the Summit website and order two items: 100% Case Acceptance and also The Hygiene Factor. Do this and watch your profits skyrocket while your stress goes way, way down. Just click the link below and scroll down the page to find these two items. (